Background to this inspection
Updated
15 August 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection site visit activity started on 20 June 2018 and ended on 19 July 2018. It included visiting people in their own homes, speaking with people and their relatives over the telephone and speaking with staff, in person and over the telephone. We visited the office location on 20, 21 and 25 June 2018 to see the manager and office staff; and to review care records and policies and procedures.
The inspection was carried out by two adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience of caring for older people.
Prior to the inspection, we reviewed all the available information about the service. This included notifications about significant events, which the provider is required by law to send us, information available online and on social media and information from commissioners. We also reviewed information the provider had sent us in the Provider Information Return. This is a document which the provider is required to send us each year and sets out what the service does well, any improvements they plan to make, along with other key information about the service.
At the time of our inspection, there were 147 people who received a service. We visited 11 people in their own homes to speak with them about their experiences of the service. We also observed staff undertaking their duties and how they interacted with these people. We reviewed people’s care records and medicines administration records at each home visit. We spoke with an additional 11 people and three people’s relatives over the telephone. We spoke with ten staff in person during the inspection and an additional five staff over the telephone. Staff we spoke with included the registered manager, deputy manager, three care managers, office administrator, senior carers and care staff.
We reviewed a variety of records related to the management of the service including staffing rotas, policies and procedures, safety and quality audits, and three staff personnel and training records. We also looked at records of accidents and incidents, complaints and compliments and survey results.
Updated
15 August 2018
The inspection of the service took place between 20 June 2018 and 19 July 2018 and was unannounced. During the inspection we visited the offices to speak with management and review records, carried out visits to people in their own homes and spoke with people, their relatives and staff over the telephone.
The service is managed from offices in Kirkham, Lancashire. Services are provided to support people to live independently in the community. At the time of our inspection, 147 people used the service.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing.
Not everyone using the service received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
There was a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The service had systems to protect people from abuse or the risk of abuse. Staff had received training to safeguard people and were aware of how to report any concerns.
The service had systems to ensure the safe and proper management of medicines. Staff received training and their competency was assessed before they provided people with support with their medicines.
Robust recruitment processes ensured only suitable candidates were employed by the service. Staff received a comprehensive induction, ongoing training and support in order for them to provide effective care and support to people who used the service.
Staff assessed risks to people and measures were put in place to lessen risks. Accidents and incidents were reported and recorded. These were analysed by the registered manager so lessens could be learned and the risk of repeat occurrences reduced.
No one we spoke with raised any concerns about staffing. We saw the service used an electronic system to organise staff rotas. However, some people we spoke with and staff, told us some changes to rotas were not always communicated effectively. The registered manager confirmed they would address this issue following the inspection.
We found people were supported with nutrition and hydration. Staff carried out thorough assessments to ensure the service could meet the needs of people. We saw written plans of care were reviewed regularly to ensure they met people’s current needs.
People we spoke with and their relatives gave us consistently positive feedback about how the service was delivered and the approach of staff. We observed a good rapport between staff and people they supported. Staff had a good understanding of protecting people’s rights and treated each person as a unique individual.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People told us they were encouraged to raise any concerns or complaints and felt they would be taken seriously. The service had a complaints policy and we saw complaints had been investigated and responded to appropriately.
We found staff and management were open and honest and spoke of a positive culture within the service. Everyone we spoke with told us there had been improvements to the service since our last inspection. The registered manager was keen to continue to drive improvements.
We saw the registered manager used a range of methods to assess, monitor and improve the service. Regular audits and checks were carried out. Feedback was sought from people who used the service, their relatives and staff. This was used to make improvements in how the service was delivered.